Republic of the Philippines Office of the President COMMISSION ON HIGHER EDUCATION Expanded Tertiary Education Equivalency and Accreditation

Program (ETEEAP) ETEEAP APPLICATION FORM 1x1 ID Picture INSTRUCTION: Please type or clearly print your answers to all questions. Provide complete and detailed information required by the questionnaire. All the declarations that you make are under oath. Discovery of any false claim in this application form will disqualify you from participating in the program. I. PERSONAL INFORMATION 1. NAME (Last Name, First Name, Middle Name) ____________________, _______________________, ____________________ 2. Address : ________________________________________________________ Zip Code : _______________ 3. 4. 5. 6. 7. 8. Telephone No(s). ______________ Birth Date : ___________________ Birthplace : Manila Civil Status : Married Sex : Male Nationality : Filipino Languages and Dialects Spoken : Pilipino and English

9. Degree Program or field being applied for : First Priority Second Priority Third Priority : Bachelor of Engineering : ____________________________ : ____________________________

10. Statement of your goals, objectives or purposes in applying for the degree. ___ 11. Indicate how much time you plan to devote for personal learning activities so that you can finish the requirements in the prescribed program. Be specific.
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Formal Education Course/Degree Program Name of School/Address Inclusive Dates of Attendance Note : All entries should be supported by authenticated photocopy of appropriate certificates/documents obtained from the institution through the program. How soon do you need to complete equivalency/accreditation? _____ 1 year _____ 3 years _____ more than 5 years _____ less than one (1) year _____ 2 years _____ 4 years II. when you plan to come to the Philippines) __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 13. 1. (e. describe how you plan to obtain accreditation/equivalency. and the like. For overseas applicants. Title of Training Program Title of Certificate Obtained Inclusive Dates of Attendance Page 2 of 8 Property of CHED-ETEEAP .g. non-formal and informal learning experiences. Non-Formal Education Non-formal education refers to structured and short-term training programs conducted for a particular purpose such as skills development.__________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 12. 2. values orientation. EDUCATION: This section will require you to provide information on your past formal.

Describe actual functions and responsibilities in position occupied: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 8. _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 7. Name and Address of Company __________________________________________________ __________________________________________________ 4. Reason(s) for moving on to the next job. Name and Designation of Immediate Supervisor _______________________________________________ _______________________________________________ 6. III. PAID WORK AND OTHER EXPERIENCES 1. Inclusive Dates of Employment From : __________________ to __________________ 3. Post/Designation _____________________________________________ 2. 3.Note : All entries should be supported by authenticated photocopy of appropriate certificates/documents obtained from the institution through the program. Terms/Status of Employment ______________________________ 5. Other Certification Examinations Please give detailed information on certification examinations taken for vocational and other skills. In case of self-employment. name three (3) reference persons: _________________________________________________ _________________________________________________ Page 3 of 8 Property of CHED-ETEEAP . Title of Certification Examination Name/Address of Certifying Agency Date Certified Rating Note : All entries should be supported by authenticated photocopy of appropriate certificates/documents obtained from the institution through the program.

outstanding accomplishments. HONORS. 1. following the above format. community and civic organizations. products of visual performing arts. exceptional accomplishments in sports. musical work. cultural and Page 4 of 8 Property of CHED-ETEEAP . CREATIVE WORKS AND SPECIAL ACCOMPLISHMENTS In this section. please describe all the awards you have received from schools. Examples of these are inventions. IV. as well as citations for work excellence. AWARDS. social. AND CITATIONS RECEIVED In this section. community service._________________________________________________ Note : Use another sheet if necessary. Work Related Award/Citation Award Conferred Name and Address of Conferring Organization Date Awarded V. Community and Civic Organization Award/Citation Award Conferred Name and Address of Conferring Organization Date Awarded 3. published and unpublished literary fiction and non-fiction writings. enumerate the various creative works you have accomplished and other special accomplishments. etc. Academic Award Award Conferred Name and Address of Conferring Organization Date Awarded 2.

watching Negosiyete on a regular basis can be considered a learning opportunity. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 3. Date Accomplished : ________________________ 3. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 2. Name and Address of Publishing Agency (if written. Description : _____________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 2. 1. being assigned to projects beyond your usual job description where you learned new skills and knowledge. please indicate the various life experiences from which you must have derived some learning experience. For example. which can lead one to conclude the level of expertise you have obtained on certain fields of interest.g. VI. 1. Please do not include formal training programs you Page 5 of 8 Property of CHED-ETEEAP . Work-Related Activities Some work-related activities are occasions for you to learn something new. or an Association/Institution which can attest to the quality of the work. LIFELONG LEARNING EXPERIENCE In this section. Include also participation in competitions and prizes obtained. Hobbies/Leisure Activities Leisure activities which involve rating of skills for competition and other purposes (e. published work). Please include here unpaid volunteer work. “belt concept in Tae-kwon-do) may also indicate your level for ease in evaluation. etc. following the same format.leisure activities. Special Skills Note down those special skills which you think must be related to the field of study you want to pursue. On the other hand. ______________________________________________________ __________________________________________________________________ __________________________________________________________________ Note : Use additional sheet if necessary.

project organizing or coordination. employment. (e. Page 6 of 8 Property of CHED-ETEEAP . your community.already cited. sports coaching.g. Travels : Cite places visited and purpose of travel Include a write-up of the nature of travel undertaken. and are related to the course you are applying for credit. and the like) __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 5. society. the foregoing claims and information I have disclosed are true and correct. business or other purposes. you may include here experiences which can be classified as on-the-job training or apprenticeship. and country? _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ I declare under oath that. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ VII. your workplace. To sum up please write an essay on how your attaining a degree contribute to your personal development. organizational leadership. on this ______ day of ________________________. However. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 4. Done in ________________________________. Volunteer Activities List only volunteer activities that demonstrate learning opportunities. State in clear terms what new learning experience was obtained from these travels and how it helped you become a better person. counseling programs. whether for leisure.

Signed : ____________________________________________ Printed Name and Signature of Applicant Community tax Certificate ________________________ Issued on _____________________________ at ____________________________ Qualifications of the Candidates The basic qualifications of the candidate are the minimum criteria for an applicant to qualify for admission to the program. he must submit any of the following evidences: 1) certificate of proficiency issued by the government regulatory body. Presentation of authentic certificates from any of these two bodies shall be considered a straightforward compliance of this requirement. the HEIs shall authenticate the documents before these are accepted as valid certification of a candidate’s proficiency. The deputized HEIs have the prerogative to add on to these their own admission criteria. Furthermore. 2) certificate of proficiency issued by the employer(s). 5. some supervisory responsibilities. . Ability of the candidate to submit an accomplished ETEEAP Application Form. The Professional Regulation Commission also gives licensure examinations for certain technician occupations. The certificate of proficiency in some fields can be obtained from the Technical Education and Skills Development Authority (TESDA). 3. or 4) a business registration certificate. He/She must be able to cope with the discipline required in the alternative learning program should he/she opt to avail of the competency enhancement scheme. This ensures that competencies for basic skills and functional knowledge must have been obtained in preparation for tertiary level education. 4. The candidate must show a certification that he has achieved a certain level of competence in the discipline for which he/she aspires a degree. The candidate must have been employed for an aggregate of five (5) years in industry related to the academic degree program or discipline he is vying for. The candidate must demonstrate substantial experience in the field related to the degree program. The candidate must be at least 22 years old. and opportunity to function within an organization. The candidate must be mature and responsible in order to succeed in the rigorous process of assessment. The ETEEAP Application Form is a package of information intended to assist the HEI faculty and staff to determine whether the applicant is eligible or not for the program. Page 7 of 8 Property of CHED-ETEEAP 2. To validate this. The candidate must possess a high school diploma or the PEPT placement equivalent to first year college. The candidate must be proficient in a branch of the discipline applied for. He/She must present a birth certificate to support the claim. He must have experiences in decisionmaking and planning. The candidate must have graduated from high school or obtained a PEPT placement at first year college. 1. 3) certificate of proficiency issued by a licensed practitioner in the field (where applicable).

skills and attitudes relevant to a particular discipline. and prior learning obtained by individuals from non formal and informal education experiences. write or visit: The ETEEAP Secretariat Unit E. AB Psychology. Shaw Blvd. BS Chemistry Teaching. 426-6001 loc. skills demonstration and other creative assessment methodologies. higher education institutions may administer competency-based evaluation. A Panel of Assessors is convened to determine the candidates’ knowledge. 434-4124 BS Social Work. BS Mathematics Teaching. 521-4063 Page 8 of 8 Property of CHED-ETEEAP . MA in Childhood Education.For inquiries. interview. Bachelor in Early Childhood Education. Master of Arts (different specialization). BS Journalism. BS Political Science. 1996 as an offshoot of the recommendation of the First Employment Summit in September 1995. MA Human Resource and Values Development. AB-BSE in English. MA in Mass Communication TECHNOLOGICAL UNIVERSITY OF THE PHILIPPINES Tel No. POLYTECHNIC UNIVERSITY OF THE PHILIPPINES Tel No. 2/F Karina Bldg. 426-6078. Bachelor in Secondary Education. and a consequently equivalent credit and appropriate certificates and degrees are awarded by administering higher education institutions. 527-0372. skills. 524-0563 Bachelor of Science in Engineering (all majors) MIRIAM COLLEGE Tel No. Bachelor in Cooperatives. 716-7832 to 45 loc. MA Education. BS Business Administration. Pasig City What is the ETEEAP? The Expanded Tertiary Education Equivalency and Accreditation Program (ETEEAP) is an educational assessment scheme which recognizes knowledge. The mandate to implement the program is embodied in Executive Order 330 issued by President Fidel V. MA Environmental Studies PHILIPPINE NORMAL UNIVERSITY Tel No. LIST OF PARTICIPATING INSTITUTIONS IN NCR ATENEO DE MANILA UNIVERSITY Tel No. BS Broadcast Journalism. 224 BS Sociology. major Environmental Education. By establishing equivalency competence standards and a comprehensive assessment system employing written test. MA Family Psychology and Education. 5131 Various degree programs DE LA SALLE UNIVERSITY Tel No. Ramos on May 13. 302-7769 Bachelor in Elementary Education.. BS Physics Teaching.

731-5709 (Registrar’s). Bachelor of Computer Science. BS Industrial Education.Bachelor of Technology. Bachelor of Engineering. MA in Technology UNIVERSITY OF SANTO TOMAS Tel No. 731-4041 ( CoE). major in various courses. BS Engineering (ECE). BS Nursing Page 9 of 8 Property of CHED-ETEEAP . Bachelor of Technician Teacher Education. 731-5738 (CoN) AB Journalism.